Filtered By:
Specialty: Internal Medicine
Source: Evidence-Based Medicine
This page shows you your search results in order of relevance. This is page number 8.
Order by Relevance | Date
Total 156 results found since Jan 2013.
ACE inhibitors are associated with a reduction in all-cause mortality versus angiotensin II receptor blockers in patients with diabetes mellitus
Commentary on: Cheng J, Zhang W, Zhang X, et al.. Effect of angiotensin-converting enzyme inhibitors and angiotensin II receptor blockers on all-cause mortality, cardiovascular deaths, and cardiovascular events in patients with diabetes mellitus: a meta-analysis. JAMA Intern Med 2014;174:773–85. Context Renin-angiotensin system blockade has been proven to reduce mortality and morbidity in populations at high risk for cardiovascular events. This extends to the patients with diabetes mellitus, where evidence-based guidelines recommend first -line treatment with ACE inhibitors (ACEIs) or angiotensin II receptor blockers...
Source: Evidence-Based Medicine - November 19, 2014 Category: Internal Medicine Authors: Harel, Z., Silver, S. A. Tags: Epidemiologic studies, Immunology (including allergy), Drugs: cardiovascular system, Drugs: CNS (not psychiatric), Stroke, Hypertension, Ischaemic heart disease, Diabetes, Guidelines Therapeutics Source Type: research
Psychological therapies help reduce headache and non-headache pain in children and adolescents
Commentary on: Eccleston C, Palermo TM, Williams AC, et al.. Psychological therapies for the management of chronic and recurrent pain in children and adolescents. Cochrane Database Syst Rev 2014;5:CD003968. Context Chronic and recurrent pain, especially in the head, abdomen and limbs affects up to 30% of children and adolescents.1 Pain can be severely disabling, disrupting school and social activities and if left untreated, may extend towards adulthood. Increasing evidence shows that psychological factors are pivotal in the transition from acute to chronic disabling pain. As a result, psychological interventions have been ...
Source: Evidence-Based Medicine - November 19, 2014 Category: Internal Medicine Authors: Vlaeyen, J. W. S., Gatzounis, R. Tags: Palliative care, Clinical trials (epidemiology), Headache (including migraine), Pain (neurology), Stroke, Child and adolescent psychiatry, Complementary medicine Therapeutics Source Type: research
Questions linger over POISE-2 and perioperative aspirin management
Commentary on: Devereaux PJ, Mrkobrada M, Sessler DI, et al.. Aspirin in patients undergoing noncardiac surgery. N Engl J Med 2014;370:1494–503. Context Aspirin therapy for secondary prevention in patients with cardiovascular (CV) disease was catalysed by the Antithrombotic Trialists’ Collaboration meta-analysis in which antiplatelet therapy (primarily aspirin) demonstrated a 22% reduction in mortality from any vascular cause.1 Based on this meta-analysis and American Heart Association (AHA) guidelines, high-risk patients (those with coronary artery, cerebrovascular or peripheral vascular disease) should be pre...
Source: Evidence-Based Medicine - November 19, 2014 Category: Internal Medicine Authors: Gerstein, N. S., Charlton, G. A. Tags: Epidemiologic studies, Drugs: cardiovascular system, Stroke, Interventional cardiology, Ischaemic heart disease Therapeutics Source Type: research
Effects of screening and lifestyle counselling on incidence of ischaemic heart disease in general population are limited
Commentary on: Jorgensen T, Jacobsen RK, Toft U, et al.. Effect of screening and lifestyle counselling on incidence of ischaemic heart disease in general population: Inter99 randomised trial. BMJ 2014;348:g3617. Context While mortality rates from cardiovascular diseases—particularly ischaemic heart disease (IHD)—have been declining in Western countries, IHD still contributes a significant burden to individuals, healthcare systems and society.1 Therefore, IHD prevention efforts could have major impact on societal health. Given the widespread prevalence of IHD and IHD risk factors, population-focused public healt...
Source: Evidence-Based Medicine - January 21, 2015 Category: Internal Medicine Authors: Lear, S. A. Tags: Rehabilitation medicine, Smoking and tobacco, Epidemiologic studies, Drugs: cardiovascular system, Stroke, Diet, Ischaemic heart disease, Screening (epidemiology), Health education, Screening (public health), Smoking Therapeutics/Prevention Source Type: research
Aiming too high or too low? Searching for the appropriate therapeutic thresholds in hypertension is not over yet
Commentary on: Rodriguez CJ, Swett K, Agarwal SK, et al.. Systolic blood pressure levels among adults with hypertension and incident cardiovascular events: the Atherosclerosis Risk in Communities Study. JAMA Intern Med 2014;174:1252–61. Context Increased arterial blood pressure (BP) is an established and modifiable cardiovascular (CV) risk factor. Consequently, the decision on antihypertensive treatment has been in the focus of changing recommendations over the past decades, initially with higher accepted BP thresholds than those recommended by modern guidelines. However, recently published consensus statements have ...
Source: Evidence-Based Medicine - January 21, 2015 Category: Internal Medicine Authors: Fedorowski, A. Tags: EBM Prognosis, Epidemiologic studies, Drugs: cardiovascular system, Stroke, Hypertension, Ischaemic heart disease Source Type: research
Mendelian randomisation meta-analysis sheds doubt on protective associations between 'moderate' alcohol consumption and coronary heart disease
Commentary on: Holmes M, Dale C, Zuccolo L, et al.. Association between alcohol and cardiovascular disease: Mendelian randomisation analysis based on individual participant data. BMJ 2014;349:g4164. Context A protective association between low-dose alcohol and risk of coronary heart disease (CHD) has been suggested by meta-analyses of observational studies and experimental studies. Observational studies are, however, vulnerable to residual confounding and selection bias. Compared with observational studies, the Mendelian randomisation (MR) approach can mitigate confounding, is immune to reverse causation, and is consistent...
Source: Evidence-Based Medicine - January 21, 2015 Category: Internal Medicine Authors: Chikritzhs, T. N., Naimi, T. S., Stockwell, T. R., Liang, W. Tags: Genetics, Drugs: cardiovascular system, Stroke, Hypertension, Ischaemic heart disease, Alcohol, Health education Aetiology/Harm Source Type: research
Meta-analysis compares anticoagulant strategies in patients with acute myocardial infarction undergoing primary percutaneous coronary intervention
Commentary on: Bangalore S, Toklu B, Kotwal A, et al. Anticoagulant therapy during primary percutaneous coronary intervention for acute myocardial infarction: a meta-analysis of randomised trials in the era of stents and P2Y12 inhibitors. BMJ 2014;349:g6419 Context Optimal anticoagulant therapy in patients receiving primary intervention for acute myocardial infarction (MI) is widely debated. Prior studies have been heterogeneous in doses and concomitant treatments such that it has been unclear whether effects have been those of newer medication or a result of changes in these co-interventions. A meta-analytic approach can ...
Source: Evidence-Based Medicine - March 17, 2015 Category: Internal Medicine Authors: Patti, G. Tags: Clinical trials (epidemiology), Drugs: cardiovascular system, Stroke, Interventional cardiology, Ischaemic heart disease, Venous thromboembolism, Radiology, Clinical diagnostic tests Therapeutics/Prevention Source Type: research
The 'surprise' question may improve the accuracy of GPs in identifying death in patients with advanced stage IV solid-cell cancer
Commentary on: Moroni M, Zocchi D, Bolognesi D, et al.; on behalf of the SUQ-P group. The ‘surprise’ question in advanced cancer patients: a prospective study among general practitioners. Palliat Med 2014;28:,959–64. Context The ‘surprise’ question has been developed in order to improve the ability of clinicians to identify patients who are at risk of dying in the near future. The question, ‘Would I be surprised if this patient died in the next year?’ shifts the focus away from precise identification of dying patients to identifying patients who might be dying.1 This may enable mor...
Source: Evidence-Based Medicine - March 17, 2015 Category: Internal Medicine Authors: Rhee, J., Clayton, J. M. Tags: EBM Prognosis, Pancreas and biliary tract, Palliative care, Epidemiologic studies, General practice / family medicine, Stroke, Prostate Source Type: research
Lung cancer CT screening is cost-effective but implementation matters
Commentary on: Black WC, Gareen IF, Soneji SS, et al.; National Lung Screening Trial Research Team. Cost-effectiveness of CT screening in the National Lung Screening Trial. N Engl J Med 2014;37:1793–802. Context The National Lung Screening Trial (NLST) revealed a 20% reduction in lung cancer mortality from three annual low-dose CT screening scans compared with chest radiographs in high-risk individuals.1 Since up to 10 million individuals in the USA may qualify for annual CT screening, policymakers have legitimately questioned whether the benefits of lung cancer screening justify the potential high costs of large-sca...
Source: Evidence-Based Medicine - March 17, 2015 Category: Internal Medicine Authors: Goulart, B. Tags: Smoking and tobacco, Health policy, Epidemiologic studies, Stroke, Screening (oncology), Radiology, Clinical diagnostic tests, Radiology (diagnostics), Screening (epidemiology), Health economics, Health service research, Health education, Screening (publi Source Type: research
Prolonged dual antiplatelet therapy after drug-eluting stent reduces the risk of stent thrombosis and major cardiovascular events but increases the rate of bleeding
This study is an international, randomised, placebo-controlled trial that was designed to determine the benefits and risks of continuing DAPT beyond 1 year after the placement of a coronary stent. The study enrolled 9961 patients. After 12 months of DAPT, patients were randomly assigned to continue thienopyridine treatment or to receive placebo for another 18 months, all...
Source: Evidence-Based Medicine - May 22, 2015 Category: Internal Medicine Authors: Helft, G. Tags: Epidemiologic studies, Drugs: cardiovascular system, Stroke, Interventional cardiology, Ischaemic heart disease, Venous thromboembolism, Guidelines Therapeutics/Prevention Source Type: research
Invasive revascularisation in patients with moderate intermittent claudication provides a significant improvement in quality of life compared with conservative treatment
Commentary on: Nordanstig J, Taft C, Hensäter M, et al. Improved quality of life after 1 year with an invasive versus a noninvasive treatment strategy in claudicants: one-year results of the Invasive Revascularization or Not in Intermittent Claudication (IRONIC) Trial. Circulation 2014;130:939–47 . Context In cases of severe intermittent claudication (IC), successful revascularisation provides significant symptomatic improvement. In cases of mild IC, revascularisation has exceedingly high risks. The choice between invasive revascularisation and non-invasive treatments for moderate severity IC is often diffi...
Source: Evidence-Based Medicine - May 22, 2015 Category: Internal Medicine Authors: Kurklinsky, A. K. Tags: Epidemiologic studies, Pain (neurology), Stroke Therapeutics/Prevention Source Type: research
Angina may trump ischaemia in predicting stable coronary artery disease outcomes, but most cardiovascular events occur in patients without angina or asymptomatic ischaemia
Commentary on: Steg PG, Greenlaw N, Tendera M, et al., Prospective Observational Longitudinal Registry of Patients With Stable Coronary Artery Disease (CLARIFY) Investigators. Prevalence of anginal symptoms and myocardial ischemia and their effect on clinical outcomes in outpatients with stable coronary artery disease: data from the International Observational CLARIFY Registry. JAMA Intern Med 2014;174:1651–9 . Context The presence of angina portends a poor prognosis. Greater attention has recently been directed to asymptomatic ischaemia, the severity of which plays a role in development of chest pain1 and is a robus...
Source: Evidence-Based Medicine - May 22, 2015 Category: Internal Medicine Authors: Kones, R., Rumana, U. Tags: EBM Prognosis, Epidemiologic studies, Drugs: cardiovascular system, Pain (neurology), Stroke, Interventional cardiology, Ischaemic heart disease Source Type: research
Cannabinoids fail to show evidence of slowing down the progression of multiple sclerosis
Commentary on: Ball S, Vickery J, Hobart J, et al. The Cannabinoid Use in Progressive Inflammatory brain disease (CUPID) trial: a randomised double-blind placebo-controlled parallel-group multicentre trial and economic evaluation of cannabinoids to slow progression in multiple sclerosis. Health Technol Asess 2015;19:1–187. Context Despite the increasing number of effective disease modifying therapies for multiple sclerosis (MS), there are no effective therapies for the progressive, neurodegenerative phase of the disease. There is now abundant experimental evidence that cannabinoids and the endocannabinoid system are ...
Source: Evidence-Based Medicine - July 24, 2015 Category: Internal Medicine Authors: Pryce, G., Baker, D. Tags: Clinical trials (epidemiology), Editor's choice, Immunology (including allergy), Drugs: CNS (not psychiatric), Stroke, Dentistry and oral medicine Therapeutics/Prevention Source Type: research
Long-term ticagrelor therapy in patients with prior myocardial infarction significantly reduces ischaemic events, albeit with increased bleeding
Commentary on: Bonaca MP, Bhatt DL, Cohen M, et al., PEGASUS-TIMI 54 Steering Committee and Investigators. Long-term use of ticagrelor in patients with prior myocardial infarction. N Engl J Med 2015;372:1791–800. Context Dual antiplatelet therapy (DAPT) with aspirin and a P2Y12 receptor antagonist constitute the cornerstone of treatment in patients with acute coronary syndrome (ACS) with a recommended duration of 1 year.1 Nevertheless, high rates of atherothrombotic events, for which platelet activation is heavily implicated, still occur at later stages.2 Therefore, a longer duration of DAPT appears intuitive, a...
Source: Evidence-Based Medicine - July 24, 2015 Category: Internal Medicine Authors: Alexopoulos, D. Tags: Epidemiologic studies, Drugs: cardiovascular system, Stroke, Ischaemic heart disease, Diabetes Therapeutics/Prevention Source Type: research
Type 2 diabetes mellitus screening has no effect on mortality
Commentary on: Selph S, Dana T, Blazina I, et al. Screening for type 2 diabetes mellitus: a systematic review for the U.S. Preventive Services Task Force. Ann Intern Med 2015; 162:765–6. Context Screening for type 2 diabetes mellitus in asymptomatic persons could lead to early identification and treatment, and potentially result in improved outcomes. In 2008, the U.S. Preventive Services Task Force (USPSTF) recommended diabetes screening in asymptomatic adults with sustained blood pressure (BP) greater than 135/80 mm Hg. Unfortunately, the USPSTF found insufficient evidence to assess the balance of benefits...
Source: Evidence-Based Medicine - July 24, 2015 Category: Internal Medicine Authors: Yoon, U. Tags: Epidemiologic studies, Drugs: cardiovascular system, Heart failure, Stroke, Hypertension, Diet, Obesity (nutrition), Screening (epidemiology), Diabetes, Health education, Screening (public health) Therapeutics/Prevention Source Type: research
